Lazaro Gamio / Axios

It's hard to think of another Cabinet secretary in recent memory who's been as hostile to part of his duties as Health and Human Services secretary Tom Price is to overseeing the Affordable Care Act.

  • Most new administration come in with some reservations about their predecessors' policy decisions and aims to nudge things in a new direction — but that's hardly the same thing as producing P.R. materials attacking a law you're supposed to be implementing, and reportedly using money set aside to promote that program.
  • "If you believe in the rule of law, then those reservations notwithstanding, the executive branch has a duty to execute the laws," said William Galston, who served in the early days of the Clinton administration and now chairs the governance studies program at the Brookings Institution.

Price has been one of the administration's loudest critics of the ACA, and HHS has disparaged the law even in updates about its progress. But it's still up to HHS and the IRS to carry out the ACA's most significant provisions.

For context:

  • Democrats never loved Medicare Advantage, the partially privatized program created under the George W. Bush administration, and didn't love the structure of Medicare's prescription-drug benefit, either.
  • But when President Obama came into office, his administration carried out those programs relatively normally. It tried to cut Medicare Advantage payments a few times, but it didn't run ads or put top officials on TV trying to discourage enrollment. The parts of the drug benefit it didn't like were changed in the ACA.
  • The closest parallel, Galston said, would be the tug-of-war between administrations at the Environmental Protection Agency, which has been sued in the past for refusing to carry out responsibilities it had been tasked with. If Price goes that far, he also could face the threat of legal action.

Yes, but: "This is an unusual case," said Mark McClellan, who oversaw Medicare, Medicaid and the FDA during the Bush administration, citing the problems the ACA has experienced on the ground — even with the Obama administration's aggressive effort to make it work as well as possible.

"This has been a little bit more fragile," he said. "To me what seems likely is markets continuing to limp along in some states unless administration decides to do something much more active" to disrupt those markets.

Go deeper

Miriam Kramer, author of Space
4 mins ago - Science

NASA confirms water exists on sunny parts of the Moon

Photo: NASA/JPL/USGS

Water on the Moon might be more easily accessible than previously thought, opening up new possible avenues for future human exploration, according to a new study.

Why it matters: NASA is aiming to send people back to the Moon as part of its Artemis program by 2024, with plans to eventually create a sustainable presence on the lunar surface. That sustainability relies on mining the moon for its resources, like water.

Updated 33 mins ago - Politics & Policy

Pence no longer expected at Amy Coney Barrett's final confirmation vote

Photo: Ben Hasty/MediaNews Group/Reading Eagle via Getty Images

Vice President Mike Pence no longer plans to attend the Senate's final confirmation vote for Judge Amy Coney Barrett on Monday, following Senate Democrats' claims that his presence after possible exposure to the coronavirus would be a "violation of common decency," a Pence aide confirmed to CNN and Politico on Monday.

Driving the news: Five of Pence's aides were recently diagnosed with COVID-19, including his chief of staff, who is currently quarantining. Pence has continued his campaign travel despite his possible exposure, which goes against CDC guidelines.

Updated 35 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Politics: The swing states where the pandemic is raging — Ex-FDA chief: Pence campaigning after exposure puts others at risk — Pence no longer expected to attend Barrett confirmation vote after COVID exposure.
  2. Health: 13 states set single-day case records last week — U.S. reports over 80,000 new cases for second consecutive day.
  3. Business: Where stimulus is needed most.
  4. Education: The dangerous instability of school re-openings.
  5. World: Restrictions grow across Europe.
  6. Media: Fox News president and several hosts advised to quarantine.